The European Commission is determined to further strengthen its antimicrobial resistance action for the period beyond 2016, an EU official has told EurActiv.com, dismissing allegations that the EU executive lacks the political will to do so.

According to the World Health Organisation, antimicrobial resistance (AMR) is the ability of a microorganism – like bacteria and viruses – to stop an antimicrobial, especially antibiotics, from working against it.

Drug resistance, which is mainly caused by the excessive and inappropriate use of antimicrobial medicines like antibiotics, poses severe threats to human health. As the standard treatments become ineffective, infections develop and spread to others.

A combination of factors like patients’ poor knowledge on the issue as well as doctors’ inclination to administrate antibiotics “very easily” have helped drug resistance significantly grow (see background).

Doctors’ role

For the European Public Health Alliance (EPHA), a public health advocacy group, changing the approach on antibiotics will not be easy and requires continuous efforts.

EPHA’s President, Archie Turnbull, told EurActiv.com that the reason for the increased use of antibiotics was that patients and the medical community have not taken on board the fact that the resistance develops.

He stressed that instead of using antibiotics as an emergency or as a last resort, they are used as first defence line from an infectious attack.

“There has been a tendency generally for doctors to give antibiotics for something much milder,” Turnbull said. “Instead of reserving the antibiotics for something more serious, this has become common,” he added, saying the situation is similar in the animal husbandry sector.

“It’s prescribed as preventive, so instead of using it for treating a disease it’s used to prevent a disease,” Turnbull said. “It’s given as a vaccination in a way”.

“Animals given antibiotics, especially beef in the US, put on more weight rapidly. So they are also used for physical and growth reasons.”

What’s the solution?

For Turnbull, the only solution is specific education for doctors, pharmacists and patients.

“Do not run to six different doctors if the first doctor does not give you antibiotics. Several people do it because some doctors refuse to prescribe it”.

Pharmaceutical companies are also beginning to play a role and already work with doctors, providing them with education material and treatment information on how to use a drug under particular circumstances.

Commission’s action plan

In 2011, the EU executive adopted an action plan against rising threats from antimicrobial resistance. The scheme is due to expire in November.

At a conference last week (9 September) in Brussels, EPHA accused the European Commission of “negligent response to the biggest health threat of the 21st century”.

In a statement issued after the conference, EPHA suggested that Xavier Prats-Monné, the Commission Director-General in charge of health, lacked support to tackle AMR at higher levels in the EU executive.

“Prats-Monné explained that lack of commitment outside his DG is the main obstacle to an action plan on AMR for 2017,” the statement read.

The Commission’s apparent reluctance to tackle AMR is remarkable because the issue is a rare subject of consensus among health organisations and the pharma industry.

EPHA and the European Federation of Pharmaceutical Industries and Association (EFPIA) sent a letter to European Commission President Jean-Claude Juncker yesterday (15 September), urging him to take immediate action on the European AMR action plan. In the letter, they also expressed their disappointment that the State of the Union speech by Commission chief Jean-Claude Juncker did not focus on Europe’s role in health.

However, Commission sources told EurActiv that the State of the Union speech, and yesterday’s material, did not reflect the Commission Work programme, which is expected in the autumn.

Contacted by EurActiv, a Commission spokesperson stressed that, on the first case, the EPHA statement did not accurately reflect the discussion.

“In particular, it is incorrect to state that Director General Xavier Prats implied a lack of political will of the Commission or other DGs on AMR. What he said is that there is no confirmation of a new EU Action Plan on AMR when the current one expires because the Commission’s Work Programme for 2017 has not been adopted yet,” the Commission official noted.

Asked to comment on the open letter, the same official highlighted “once more” that the executive would keep AMR high on its political agenda.

“The 2011 European Commission Action Plan on AMR is due to be evaluated and we seek to renew and scale up activities with EU added value on AMR for the period beyond 2016,” the spokesperson stressed.

“Future Commission strategic actions aim to make EU a best practice region on AMR, to promote research and innovation for new antimicrobials, also for alternatives and to strengthen international action on AMR,” the EU official concluded.

Background

Medical experts predict that drug-resistant infections could result in 10 million deaths per year by 2050, while economic losses could reach €89 trillion. Practically, experts warn that if no serious action is taken common illnesses and minor surgeries could become “high-risk procedures”.

On an EU level, 25,000 people die each year from an infection due to antibiotic-resistant bacteria. A Eurobarometer survey published this year (June 2016) found a 6% decrease in consumption of antibiotics in the last years even though some countries are still showing an increase in their consumption.

In addition, knowledge in antimicrobial resistance remains low. A significant number of Europeans were not aware of the fact that antibiotics are ineffective against viruses (57%), cold and flu (44%). Moreover, the main and most trustworthy source of information on antibiotics is the doctors (84%) followed by pharmacies (37%) and hospitals (19%).